慢性住院精神分裂病患者對禁菸政策意見之因素探討

Exploring the Factors Associated with Opinions about the new No Smoking Policy among Chronic Schizophrenia Inpatients

吸菸對於健康造成的傷害已有明確的科學驗證，國內為落實防制菸害，新修正之菸害防制法已於民國98年開始實施，醫療院所屬於全面禁菸之場所，但研究發現，精神科病患的吸菸比率遠高於一般族群，精神科病患能否遵從禁菸規定，避免菸害，是落實菸害防制工作的重要因素，值得探討。本研究目的為分析長期住院之慢性精神分裂病患吸菸者對於醫院禁菸意見之相關因素，以提供精神醫療院所全面推行禁菸政策之參考。本研究屬橫斷性研究，採立意取樣，針對中部地區某公立精神療養醫院慢性病房的精神分裂症患者，以結構式問卷進行問卷分析，共回收247份有效問卷，並運用SP SS12.0統計軟體，進行統計分析。本研究結果發現，247位有吸菸行為之受訪者中，有88位(35.6％)受訪者支持醫院全面禁菸，有159位(64.4％)受訪者不支持。利用迴歸分析，影響精神病患支持醫院推行禁菸政策的相關變數包為家人是否贊成病患吸菸，家人無意見或支持病患吸菸者，其支持醫院全面禁菸的勝算比相較於家人不贊成病患吸菸者，分別為0.239 95％CI=0.122- 0.470)及0.433(95％C I=0.122-0.470)，均達統計上之顯著差異水準(P<0.05)。建議衛生主管機關應加強針對病患家屬設計有效的宣導計畫，以強化病患接受醫院禁菸之政策。

The health hazards of smoking are well documented. The new TOBACCO HAZARDS PREVENTION ACT was put into practice in Taiwan in 2009. According to this law, cigarette smoking is completely prohibited in hospitals. It has been found that the prevalence of smoking by psychiatric patients is higher than that in the general population. The purpose of this study was to explore the factors associated with opinions about this no-smoking policy among chronic schizophrenic inpatients. This research was based on a cross-sectional survey. A structured questionnaire was administered to 247 chronic schizophrenic patients who were smokers in a psychiatric hospital in central Taiwan. The results revealed that 35.6% (88 people) of the study sample supported the no-smoking policy in the hospital. According to the results of regression analysis, family support for patients’ smoking was the most significant variable related to their opinion about the no-smoking policy. The odds ratio for patients who supported the no-smoking policy was 0.239 (95% CI=0.122-0.470, p<0.05) if their family members did not want the patients to smoke and it was 0.433 (95% CI=0.122-0.470, p<0.05) if family members agree that patients should smoke. Health authorities should design effective intervention programs for family members in order to promote support for the no-smoking policy among chronic schizophrenic patients.